How to Pass the Meaningful Use Driver’s Test

February 14, 2011

As practices across the country start joining the Meaningful Use gold rush, it may be worth taking a moment to ask: What do I have to do? And why does the government want me to do this?

As practices across the country start joining the Meaningful Use gold rush, it may be worth taking a moment to ask: What do I have to do? And why does the government want me to do this?

Let's start with the first question:

Meeting Meaningful Use requirements is like taking a very detailed electronic health record (EHR) driving test, in which you show to the government that you know how to "drive" an electronic health record.

To pass this driving test, you have to demonstrate that you are using your EHR in a way that allows you to meet 20 very specific requirements. Broadly speaking, these requirements either pertain to a) how you capture and store patient data, or b) specific features of the EHR that the government wants you to use.

Here's an example of a Meaningful Use requirement on the patient data side: "Maintain up-to-date problem list of current and active diagnoses. More than 80 percent of patients have at least one entry recorded as structured data." The key word is "structured data." This simply means that this piece of data is stored in the diagnoses section of the EHR's database, and can be easily retrieved with a simple computer query.

The Meaningful Use requirements are full of this type of thing. Here's another: "Maintain active medication allergy list. More than 80 percent of patients have at least one entry recorded as structured data."

From the government's perspective, the focus on structured data makes total sense. Structured data can be aggregated and analyzed; this is near impossible with unstructured data (like you might find in a narrative progress note).

Structured data also make sense for the practice-particularly if we enter an era where physicians are expected to take on quality and disease management responsibilities.

Let's switch to the EHR feature side of Meaningful Use. Here is a good one: "Generate and transmit permissible prescriptions electronically. More than 40 percent are transmitted electronically using certified EHR technology." This means that you will need to establish a connection between your EHR and the e-prescribing network (known as Surescripts)-so that scripts written on your EHR will show up as an electronic message at the local pharmacy.

Keeping on the topic of prescription writing, here is another feature-based Meaningful Use requirement: "Implement drug-drug and drug-allergy interaction checks." Most EHRs have this feature-but it does it have to be turned on, and you are likely to pay for an annual subscription fee to keep the database up-to-date.

Why does this government want us to jump through these hoops? Isn't simply having an EHR enough?

The architects of the Meaningful Use legislation correctly believe that in order for EHRs to have an impact on cost and quality, they have to be used in certain ways. This includes collecting patient data in a structured fashion so it can easily be moved, aggregated, and analyzed at the both the micro and macro level. It also means taking advantage of EHR features that make care safer, more efficient, and better for patients.

Fortunately, for practices that either have an EHR or those that are in the shopping process, the current requirements are well within the reach of most reputable EHRs. The government has helped a bit in the process by providing a certification program specifically for Meaningful Use. You can find the current certified vendors here.

Click here for more information on Meaningful Use.

Bruce Kleaveland is a paid correspondent through Intel's sponsorship with Physicians Practice.